Systematic review: psychosocial factors associated with pain in inflammatory bowel disease
Open accessAbstract
BACKGROUND: Pain is a frequently reported symptom of inflammatory bowel disease (IBD) experienced by patients in active disease and remission. Psychological factors play a significant role in pain, but have not been systematically reviewed in IBD. AIM: To review psychosocial factors associated with pain in adults diagnosed with IBD. METHODS: Electronic (PsycInfo, MEDLINE, EMBASE, Cochrane Library, CINAHL, Web of Science), and hand-searching were conducted February-May 2017. Two authors carried out screening and data extraction. RESULTS: Fifteen studies including 5539 IBD patients were identified. Emotional, cognitive-behavioural and personality factors were associated with IBD-pain. Depression and anxiety were the most commonly explored constructs, followed by perceived stress and pain catastrophising, all of which were positively associated with greater pain. Greater abdominal pain was associated with a concurrent mood disorder over fivefold (OR 5.76, 95% CI 1.39, 23.89). Coping strategies and pain fear avoidance correlated with pain levels. Perceived social support (r = .26) and internal locus of control (r = .33) correlated with less pain. Patients reporting pain in IBD remission more frequently had an existing diagnosis of a mood disorder, a chronic pain disorder and irritable bowel syndrome. Six studies controlled for disease activity, of which 4 found that psychosocial factors significantly predicted pain. The majority of studies (n = 10) were of high quality. CONCLUSION: Psychosocial factors appear to play a significant role in IBD-pain. Further research is required to explore psychosocial constructs in relation to IBD-pain, with use of validated pain measures, large sample sizes and clearer characterisation of disease activity.
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A systematic review of 15 high-quality studies concluded that emotions are associated with abdominal pain symptoms in IBD patients.
“A systematic review of 15 high-quality studies arrived at the conclusion that emotions are associated with abdominal pain symptoms in IBD patients.”
From Stress triggers flare of inflammatory bowel disease in children and adults (2019) · cites this paper as [89]
Among IBD patients, depression, anxiety, and perceived stress are common emotional disorders.
“Among IBD patients, depression, anxiety, and perceived stress are common emotional disorders (89).”
From Stress triggers flare of inflammatory bowel disease in children and adults (2019) · cites this paper as [89]
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- Authors
- Sweeney, L., Moss‐Morris, R., Czuber‐Dochan, W., Meade, L., Chumbley, G., & Norton, C.
- Affiliations
- King's College London (GB)
- Health Psychology Section King's College London London UK
- Imperial College Healthcare NHS Trust (GB)
- Corresponding author
- Sweeney, L.
- Venue
- Alimentary Pharmacology & Therapeutics
- Publisher
- Wiley
- Published
- 2018-01-22
- Volume
- 47
- Issue
- 6
- Pages
- 715-729
- ISSN
- 0269-2813 (ISSN-L)
- 1365-2036
- OpenAlex
- W2786608165
- Cited by
- 112
- References
- 80
- Citations by year
- 2026: 4 · 2025: 19 · 2024: 13 · 2023: 13 · 2022: 10 · 2021: 18 · 2020: 19 · 2019: 11 · 2018: 5
- FWCI
- 1.83
- Type
- journal article
- Language
- en
- Open access
- green
- kclpure.kcl.ac.uk
- Licence
- Locations
- Alimentary Pharmacology & Therapeutics (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion, other-oa)
- Funders
- Crohn's and Colitis UK
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- inflammatory bowel disease, pain, psychosocial factors, depression, anxiety, perceived stress, pain catastrophizing, coping strategies, social support, locus of control, mood disorders, remission, irritable bowel syndrome, abdominal pain
- MeSH terms
- Adaptation, Psychological, Adult, Anxiety, Depression, Emotions, Female, Humans, Male, Psychology, Risk Factors, Inflammatory Bowel Diseases, Abdominal Pain, Comorbidity, Irritable Bowel Syndrome
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